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Registrar, unless he is provided with a Registrar's certificate. There is no
machinery whatever for ensuring that in each case the deceased has met with his
death from natural causes, and that enquiry shall be made when this is not
established. The Coroner's Court and the spontaneous services of medical
practitioners are the only means by which the cause of death is ascertained. It
is true that in the great majority of cases, the cause of death is certified to
the Registrar in one or other of these ways, but the registration of a death may
be effected and a certificate for burial obtained without any evidence as to the
cause of death being demanded, except the statement of some inmate of the
house. Unless suspicion should arise, and some one should set in action the
office of the coroner or police, there appears nothing to prevent secret murder
passing undetected on the largest scale.
Nothing more can possibly be done in the existing state of the laws of
registration, than is now done under the excellent arrangements of the RegistrarGeneral,
but it is lamentably certain that at present many persons buried in
London, as having died from natural causes, may easily have come by their deaths
unfairly; and that this number would be vastly larger, if it were not for administrative
management unrecognized by the law.
In St. Giles's in 1860, there were twenty-four deaths registered without
either inquest or medical certificate, where the burial took place without enquiry.
And it is to feared that this facility of registration and burial is getting more
widely appreciated, for in the six months that have already elapsed of the present
year, 1861, there were as many uncertified deaths entered by the Registrars as in
the whole of 1860. The causes of death assigned in these cases is, of course, of
the most unsatisfactory kind. "Unknown," occurs in about one instance out of four.
"Consumption," "decline," and "convulsions," are samples of a kind of entry
often met with. And in other cases, without medical certificate, the cause of death
is registered as "apoplexy" "pleurisy," and even "diphtheria." There is absolutely
no evidence that a death returned as "aged 46, apoplexy, no medical attendant,"
was not a case of poisoning by opium, or that a number of children, from a few
hours to a month old, dying of an "unknown "cause, had not met with their
deaths by foul play.
Chapter VI.—On the Diseases-and Deaths in the Practice of the Workhouse
and of the Bloomsbury Dispensary.
In a parish so poor as St. Giles's, the amount of relief afforded by the
public medical institutions is large enough to constitute another kind of criterion,
though a rough one, of the comparative healthiness of different years. The
diseases that are observed in such practice, supply also important supplementary
information to the causes of death returned by the Registrar-General. As affording
accurate statistical information, the returns of these institutions are of course
not so universally available as the register of mortality, which applies to all ranks
of the community, and which is besides subject to a far smaller number of
artificial disturbing influences. Still there is interest in noting the correspondence
or discrepancy between the inferences yielded by these two sets of data as
to the health and diseases of our population. The prevalence of some ailments
that are never or rarely fatal, may also be ascertained from these institutions.
The practice of the workhouse resolves itself, as usual, into three portions.
The first comprises patients treated in the infirmary, in whom, from the often
incurable nature of their complaints, the mortality is higher than in ordinary
hospitals. The second part is among persons who apply for relief at the dispensary
of the workhouse, and among these there is scarcely ever a death, as
* The above was written before I had seen a letter from the Registrar-General to the Board, in which he
suggests that I attribute to the Local Registrar more power than he really possesses to ascertain the cause of
death. It will be seen how fully I recognize his inability to do so under the present law.—G.B.